PIH6 PREVALENCE OF ADVERSE EVENTS AMONG CHILDREN TAKING MULTIPLE VERSUS SINGLE ANTIPSYCHOTICS

Abstract

To compare the prevalence of adverse events (AEs) among children and adolescents taking single and multiple antipsychotics (APs). A retrospective observational cohort study was conducted using 2016-2018 Mississippi Medicaid administrative claims data. Inclusion criteria were prescription fills for APs during study period, age 18 years or less, continuous enrollment 6 months pre- and 12 months post-AP start date. Multiple AP users were defined as those who had at least 45 days of continuous use of 2 or more APs. Beneficiaries were excluded if they had AP use in the 6 month baseline period. Logistic regression and generalized linear models were used to assess the relationships among type of AP use (multiple or single) and AEs. The study cohort included 124 multiple AP users and 821 single AP users. During the 12-month post-period, 13.6% of the single AP users had an AE compared to 19.3% of the multiple AP users. The most common AE was suicidal ideation (9.0% for single AP users and 16.1% for multiple AP users). Controlling for age, gender, race, and pharmacy plan, multiple AP users had 2.16 times the odds [95% CI: (1.19-3.90)] of suicidal ideation as single AP users. Multiple AP users had higher rates for tachycardia (2.1% for single AP users and 4.0% for multiple AP users [OR = 1.73, 95% CI: 0.58 – 5.92] and any AE [Odds Ratio (OR) = 1.51, 95% CI: 0.89 – 2.57], but these were not statistically significant. Children and adolescents taking multiple APs have significantly greater odds of suicidal ideation compared to those taking a single AP. Even though the analysis was limited by low sample size, the results highlight the safety concerns associated with multiple AP use. Further research needs to be conducted in a larger sample to confirm these findings.